Or. Admin. Code § 411-320-0020

Current through Register Vol. 63, No. 11, November 1, 2024

Section 411-320-0020 - Definitions and Acronyms

In addition to the following definitions, OAR 411-317-0000 includes general definitions for words and terms frequently used in OAR chapter 411, division 320. If a word or term is defined differently in OAR 411-317-0000, the definition in this rule applies.

(1) "ABAS" means Adaptive Behavior Assessment System.

(2) "ABES" means Adaptive Behavior Evaluation Scale.

(3) "Adaptive Behavior" means the degree to which an individual meets the standards of personal independence and social responsibility expected for age and culture group. Other terms used to describe adaptive behavior include, but are not limited to, adaptive impairment, ability to function, daily living skills, and adaptive functioning. Adaptive behaviors are everyday living skills including, but not limited to, walking (mobility), talking (communication), getting dressed or toileting (self-care), going to school or work (community use), and making choices (self-direction).

(a) Adaptive behavior is measured by normed, standardized tests administered by a licensed clinical psychologist, school psychologist, doctor of medicine, or doctor of osteopathic medicine with specific training and experience in test interpretation of adaptive behavior scales for individuals with intellectual or developmental disabilities. An assessment of adaptive behavior is used to determine if a person has significant impairment in adaptive behavior as required in eligibility criteria OAR 411-320-0080(3) and (4). Additionally, an assessment of adaptive behavior is used to determine if a person is eligible as a person with an other developmental disability by demonstrating the person requires supports similar to a person with an intellectual disability as described in OAR 411-320-0080(4). Assessments of adaptive behavior include the following:

(A) Adaptive Behavior Assessment System (ABAS);

(B) Adaptive Behavior Evaluation Scale (ABES);

(C) Vineland Adaptive Behavior Scale (VABS); or

(D) Other assessments approved by the Department that are designed to measure adaptive behavior, standardized and normed to a population consistent with people who experience an intellectual or developmental disability.

(b) DOMAIN SCORES. Adaptive behavior domain scores are identified on the following assessments of adaptive behavior:

(A) The ABAS and ABES are:

(i) Conceptual;

(ii) Practical; and

(iii) Social.

(B) The VABS are:

(i) Socialization;

(ii) Daily living skills;

(iii) Communication; and

(iv) Motor.

(c) COMPOSITE SCORE. The adaptive behavior composite score is the overall score which results from summing two or more domain scores on a given assessment of adaptive behavior.

(d) SKILLED AREAS. Skilled areas are a particular assessed score. The skilled areas on the ABAS or ABES are the only skilled areas used for the purposes of OAR 411-320-0080 and include scaled scores in:

(A) Communication;

(B) Functional academics;

(C) Self-direction;

(D) Leisure;

(E) Social;

(F) Community use;

(G) Home and school living;

(H) Self-care;

(I) Health and safety; and

(J) Work.

(e) "Significant impairment" in adaptive behavior means:

(A) A composite score of at least two standard deviations below the norm; or

(B) Two or more domain scores, as identified in subsection (b) of this section, are at least two standard deviations below the norm; or

(C) Two or more skilled areas, as identified in subsection (d) of this section, are at least two standard deviations below the norm.

(4) "CAM" means "Centralized Abuse Management" as defined in OAR 411-317-0000.

(5) "CDDP" means "Community Developmental Disabilities Program" as defined in OAR 411-317-0000.

(6) "CIIS" means "Children's Intensive In-Home Services" as defined in OAR 411-317-0000 and described in OAR chapter 411, division 300.

(7) "CMS" means "Centers for Medicare and Medicaid Services" as defined in OAR 411-317-0000.

(8) "Completed Application" means an application required by the Department that:

(a) Is filled out accurately based on individual information, signed, and dated. An applicant who is unable to sign may sign with a mark, witnessed by another person; and

(b) Contains documentation required to make an eligibility determination as outlined in OAR 411-320-0080.

(9) "Composite Score" means the score identified by an assessment of adaptive behavior as described in the definition for "adaptive behavior".

(10) "County of Origin" means:

(a) For an adult, the county of residence for the adult; and

(b) For a child, the county where the jurisdiction of legal guardianship exists.

(11) "Current Documentation" means documentation related to the intellectual or developmental disabilities of an individual in regards to the functioning of the individual within three years from the date of application or Notice of Redetermination (form 5101). Current documentation may include, but is not limited to, an ISP, Annual Plan, Positive Behavior Support Plan, required assessments, educational records, medical assessments related to the intellectual or developmental disabilities of an individual, psychological evaluations, and assessments of adaptive behavior.

(12) "Developmental Disability" means a neurological condition that:

(a) Originates before an individual is 22 years of age;

(b) Originates in and directly affects the brain and has continued, or is expected to continue, indefinitely;

(c) Constitutes significant impairment in adaptive behavior as diagnosed and measured by a qualified professional as described in OAR 411-320-0080;

(d) Is not primarily attributed to other conditions including, but not limited to, a mental or emotional disorder, sensory impairment, motor impairment, substance abuse, personality disorder, learning disability, or Attention Deficit Hyperactivity Disorder (ADHD); and

(e) Requires training and support similar to an individual with an intellectual disability as described in OAR 411-320-0080.

(13) "Domain Score" means the score identified by an assessment of adaptive behavior as described in the definition for "adaptive behavior".

(14) "Eligibility Determination" means the decision by a CDDP or by the Department regarding the eligibility of a person for developmental disabilities services according to OAR 411-320-0080 and is either a decision that a person is eligible, presumptively eligible, or ineligible for developmental disabilities services.

(15) "Eligibility Specialist" means an employee of the CDDP, or other agency that contracts with the county or Department, that determines eligibility for developmental disabilities services.

(16) "FSIQ" means the full scale intelligence quotient. FSIQ is a broad measure of intelligence achieved through administration of a standardized intelligence test that is accepted by the Department for an eligibility determination. Any standard error of measurement value is not taken into consideration when making an eligibility determination. FSIQs obtained from administration of brief intelligence tests are not considered valid FSIQ scores when making an eligibility determination.

(17) "History" means, for the purposes of an eligibility determination as defined in this rule, necessary evidence of an intellectual disability prior to 18 years of age or an other developmental disability prior to 22 years of age, including previous assessments and medical evaluations prior to the date of eligibility determination for developmental disabilities services.

(18) "HSD" means the Health Systems Division, Medical Assistance Programs under the Oregon Health Authority.

(19) "IEP" means "Individualized Education Program" as defined in OAR 411-317-0000.

(20) "Indefinitely" means a condition or impairment that is likely to be permanent, as determined by a qualified professional.

(21) "Informal Adaptive Behavior Assessment" means:

(a) Observations of impairment in adaptive behavior recorded in the progress notes for an individual by a services coordinator, personal agent, or a trained eligibility specialist with at least two years of experience working with individuals with intellectual or developmental disabilities; or

(b) A standardized measurement of adaptive behavior, such as a Vineland Adaptive Behavior Scale (VABS) or Adaptive Behavior Assessment System (ABAS), that is administered and scored by a social worker or other professional with a graduate degree and specific training and experience in individual assessment, administration, and test interpretation of adaptive behavior scales for individuals with intellectual or developmental disabilities.

(22) "Intake" means the activity of completing the Request for Eligibility Determination (form 0552) and necessary releases of information prior to the submission of a completed application to the CDDP.

(23) "Intellectual Disability (ID)" means significantly sub average general intellectual functioning defined as full scale intelligence quotients (FSIQs) 70 and under, as measured by a qualified professional, and existing concurrently with significant impairment in adaptive behavior directly related to an intellectual disability as described in OAR 411-320-0080 that manifested prior to an individual's 18th birthday. An individual with a diagnosis of intellectual disability that manifested prior to the individual's 18th birthday and who has a valid FSIQ of 71-75, may be considered to have an intellectual disability if the individual also has significant impairment in adaptive behavior directly related to the intellectual disability as diagnosed and measured by a licensed clinical or school psychologist as described in OAR 411-320-0080.

(24) "Intellectual Functioning" means functioning as assessed by one or more of the individually administered general intelligence tests developed for the purpose of measuring intelligence. For purposes of making eligibility determinations, intelligence tests do not include brief intelligence measurements.

(25) "Intelligence Tests" approved by the Department include:

(a) Wechsler Intelligence Scales;

(b) Stanford-Binet Intelligence Scale;

(c) Woodcock-Johnson Test of Cognitive Abilities; or

(d) Any other intelligence assessment approved by the Department that are designed to measure intelligence quotients, standardized and normed to a population consistent with people who experience an intellectual or developmental disability. Brief measures of intelligence quotients are not accepted, including brief tests such as the Kaufman Brief Intelligence Test (K-BIT), Weschler Abbreviated Scale of Intelligence (WASI), or tests that only administer part of a full assessment.

(26) "IQ" means intelligence quotient.

(27) "ISP" means "Individual Support Plan" as defined in OAR 411-317-0000.

(28) "Learning Disability" means a condition that interferes with development of academic skills. Learning disability includes, but is not limited to, ataxia, communication disorder, dyslexia, dysgraphia, dyscalculia, language disorder, fluency disorder, non-verbal learning disorder, specific auditory or processing disorder, social pragmatic communication disorder, specific learning disorder, and speech sound disorder.

(29) "Licensed Medical Practitioner" means any of the following licensed professionals:

(a) Medical Doctor (MD);

(b) Doctor of Osteopathic Medicine (DO);

(c) Licensed Clinical Psychologist (Ph.D. or Psy.D.);

(d) Nurse Practitioner (NP);

(e) Physician Associate (PA); or

(f) Naturopathic Doctor (ND).

(30) "LMHA" means Local Mental Health Authority.

(31) "Management Entity" means the CDDP or private corporation that operates the Regional Program, including acting as the fiscal agent for regional funds and resources.

(32) "Military Service" means service in the Armed Forces of the United States, as defined in ORS 341.496.

(33) "Motor Impairment" means impairment in the ability to move all or parts of an individual's body caused by trauma, disease, or any condition affecting the muscular-skeletal system, spinal cord, or sensory or motor nerves. The disability may interfere with the development or function of the bones, muscles, joints, and central nervous system. Physical characteristics may include paralysis, altered muscle tone, an unsteady gait, loss of or inability to use one or more limbs, difficulty with gross-motor skills such as walking or running, or difficulty with fine-motor skills such as buttoning clothing, printing, or writing. Motor impairment includes, but is not limited to, apraxia, developmental coordination disorder, dyspraxia, motor learning difficulty, muscular dystrophy, and stereotypic movement disorder.

(34) "Neurological Condition" means a condition that originates in and directly affects the brain, leads to delays in achieving expected milestones, and is likely to cause lifelong impairments of personal, social, academic, or occupational functioning. A condition does not originate in and directly affect the brain if the condition only causes abnormalities or changes of the spinal cord, peripheral nerves, autonomic nervous system, neuromuscular junction, cardiovascular system, or musculoskeletal system. Conditions that do not originate in and directly affect the brain include, but are not limited to, muscular dystrophy, spinal muscular atrophy, and non-shunted spina bifida.

(35) "Notice of Redetermination" means the Redetermination of Eligibility for Developmental Disabilities Services (form 5101).

(36) "OSIPM" means "Oregon Supplemental Income Program-Medical" as defined in OAR 411-317-0000.

(37) "OTIS" means the Oregon Department of Human Services, Office of Training, Investigations, and Safety.

(38) "Qualified Professional" means, for the purposes of OAR 411-320-0080, any of the following licensed professionals trained to make a diagnosis of a specific intellectual or developmental disability:

(a) Licensed clinical psychologist (Ph.D., Psy.D.);

(b) Medical doctor (MD);

(c) Doctor of Osteopathic Medicine (DO); or

(d) Nurse Practitioner (NP).

(39) "Quality Management Strategy" means the Department Quality Assurance Plan for meeting the CMS waiver quality assurances as required and defined by 42 CFR 441.301 and 441.302 and State Plan K option quality assurances as required and defined by 42 CFR 441.585.

(40) "Region" means a group of Oregon counties defined by the Department that have a designated management entity to coordinate regional backup services and be the recipient and administration of funds for those services.

(41) "Regional Program" means the regional coordination that the counties comprising the region agree are delivered more effectively or automatically on a regional basis.

(42) "Request for Eligibility Determination" means the Office of Developmental Disabilities Services Request for Eligibility Determination (form 0552).

(43) "Resident" means a person that meets the Oregon residency requirements in OAR 461-120-0010. "Resident" includes a person that is absent due to military obligation, if the person intends to return to Oregon, and Oregon remains their principal establishment, home of record, or permanent home during the absence.

(44) "School-Age Testing" means any type of standardized test that may be administered for use in school supports or services beginning in Kindergarten.

(45) "Service Member" means a person who is in the military service or who has separated from military service in the previous 18 months through retirement, discharge, or other separation.

(46) "Significantly Subaverage" means a score on an intelligence test that is two or more standard deviations below the mean for the test.

(47) "Skilled Areas" means a particular assessed score as described in the definition for "adaptive behavior".

(48) "SSI" means Supplemental Security Income. SSI is administered by the Social Security Administration.

(49) "These Rules" mean the rules in OAR chapter 411, division 320.

(50) "VABS" means Vineland Adaptive Behavior Scale.

Or. Admin. Code § 411-320-0020

SPD 24-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f. & cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06; SPD 9-2009, f. & cert. ef. 7-13-09; SPD 25-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10; SPD 5-2010, f. 6-29-10, cert. ef. 7-1-10; SPD 6-2010(Temp), f. 6-29-10, cert. ef. 7-4-10 thru 12-31-10; SPD 28-2010, f. 12-29-10, cert. ef. 1-1-11; SPD 31-2011, f. 12-30-11, cert. ef. 1-1-12; SPD 22-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD 23-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14, cert. ef. 12/28/2014; APD 36-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16; APD 16-2016, f. 6-28-16, cert. ef. 6/29/2016; APD 38-2018, temporary amend filed 11/07/2018, effective 11/08/2018 through 04/30/2019; APD 43-2018, temporary amend filed 12/18/2018, effective 12/18/2018 through 04/30/2019; APD 18-2019, amend filed 04/30/2019, effective 5/1/2019; APD 45-2019, amend filed 10/29/2019, effective 11/1/2019; APD 4-2023, amend filed 04/28/2023, effective 5/1/2023; APD 43-2024, minor correction filed 07/16/2024, effective 7/16/2024

Statutory/Other Authority: ORS 409.050, 427.104, 427.105, 427.115, 427.154, 430.662 & 430.731

Statutes/Other Implemented: ORS 409.010, 427.005-427.154, 430.215, 430.610, 430.620, 430.662, 430.664 & 430.731-430.768